Teen Dentistry

According to the most recent and comprehensive dental health survey of children, teenagers have the highest risk of dental disease.  More than 40% of 12–15 year olds had some history of decay in their permanent teeth (1).

To address these issues, our schools program enables us to visit your school using our mobile clinics, provide an initial examination for students, and then offer treatment as required. 

(1) Armfield JM, Spencer AJ & Brennan DS 2009. Dental health of Australia’s teenagers and pre-teen children: the Child Dental Health Survey, Australia 2003–04. Dental statistics and research series no. 52. Cat. no. DEN 199. Canberra: AIHW.

Cosmetic & Restorative Dentistry for Children and Teens

Whitening Toothpastes: Do They Really Work?

Some teens stand in the drugstore and wonder if toothpastes with “whitening power” really work. Whitening toothpastes contain chemicals or polishing agents that can remove stains from the teeth. (That said, all toothpastes have mild abrasives that help remove surface stains.) If the teeth are darker than they used to be because of surface stains, whitening toothpastes can brighten a teen’s smile. On the other hand, if the teeth are darker because of deeper stains, perhaps from an injury or certain medications, whitening toothpastes will not give the teen effective results. Unlike bleaching, these toothpastes do not change the colour of the teeth to a whiter, brighter shade. If a teen is interesting in choosing this route, he must be sure to choose a brand that contains fluoride. Teens are still very susceptible to tooth decay.

Bleaching: Great Choices to Brighten Your Smile

Bleaching will brighten the colour of teeth that are discoloured, stained, or have been darkened as a result of injury. It changes the colour of the child or teen’s teeth without removing any tooth structure. One treatment choice is in-office bleaching. A concentrated bleaching agent is applied to his teeth and then activated with heat or light. The visits take about an hour, and usually one to four visits are needed. The dentist can lighten as few or as many teeth as needed.

One method is a bleaching kit that the child or teen can receive from the dentist and use at home. In the first visit, the dentist takes a model of the child’s teeth. In the second visit, the child picks up the custom-made bleaching tray and the bleaching gel. He wears the tray, filled with the bleaching gel, usually at night for several nights. This approach is best for older children and teens whose front permanent teeth are fully erupted. Whichever approach you choose, bleaching is fairly comfortable, and the side effects are few. Some patients find their teeth are more sensitive to hot and cold foods, but the sensitivity disappears after a few days. A toothpaste for sensitive teeth may help.

Microabrasion: Good First Choice for Tooth Stains or Spots

Microabrasion is an excellent option for children or teens who want to change the colour of certain areas or spots on the teeth, rather than lighten the colour of the whole tooth. The dentist removes microscopic bits of discoloured tooth enamel with an abrasive and a mild acid. Treatment usually can be completed in one visit. Microabrasion is a conservative treatment, removing little tooth structure.

Will microabrasion remove a spot or stain completely? It is difficult to predict. Success depends upon a number of factors, especially the type and extent of discoloration. Surprisingly, brown or dark stains are removed more readily than white ones. Microabrasion works better on surface discoloration than it does on deeper stains caused by injury or certain medications.

Bonding and Veneers: Restore The Look of Chipped, Broken and Pitted Teeth

These treatments can restore the original shape of a chipped, broken or pitted tooth. They can brighten front teeth that are stained or discoloured. The treatments involve bonding tooth-coloured plastic or cementing tooth-coloured veneers to the teeth. They require little loss of tooth structure, and they restore the natural appearance of teeth and encourage a confident smile. Bonding materials, often called composite resins, are tooth-coloured plastics. During the treatment called bonding, the bonding material is applied to the tooth, formed into the proper shape, and hardened with a light or chemical process. The treatment typically takes one or two visits.

Veneers are thin shells of tooth-coloured plastic or porcelain. They are custom-made, usually by a dental laboratory, and then bonded onto the teeth using a tooth-coloured cement. The treatment takes multiple visits. Bonding and veneer treatments may greatly improve the look of a smile and can last for several years. However, there are some limitations. Although bonding and veneers are conservative, they may require some loss of tooth enamel. Also, bonded teeth and veneers are simply not as strong as the original tooth structure. Nail biting, hard foods and sports accidents can damage them. They must be maintained with good oral hygiene and regular dental visits.

Porcelain Crowns: Strongest Treatment For Restoring Your Smile

Porcelain crowns can give beautiful cosmetic and restorative results for discoloured, chipped or broken teeth.  However, parents must consider two realities: First, crowns are more costly than other treatments; and second, a crown requires the removal of a significant amount of tooth structure. On the other hand, crowns are stronger than the other cosmetic choices and can last for many years with good dental health habits. Porcelain crowns are reserved for permanent teeth that are fully erupted with the gum tissue at its adult position.  Crowns typically are made of metal covered with tooth-coloured porcelain or a plastic resin. The tooth is prepared by shaping it and removing a part of the outside tooth structure. (The tooth must be made smaller in size so the crown can fit over it.) The crown is custom-made, usually by a dental laboratory, to precisely fit the prepared tooth. The crown fits over the tooth and is cemented into place.

Orthodontic Treatment: Advantages Go Far Beyond Cosmetics

A dentist can identify crowded or crooked teeth and actively intervene to guide the teeth as they come in the mouth. Not only will this improve the look of the child’s smile, but early orthodontic treatment may prevent more extensive treatment later.  The advantages of orthodontic care far surpass appearance. Braces and other orthodontic appliances can straighten crooked teeth, guide teeth into proper position as they come in, correct bite problems, and even prevent the need for tooth extractions. Straight teeth not only look better, but are easier to keep clean and therefore less susceptible to tooth decay and gum disease.  Unlike the other treatment choices that start and finish in a shorter period of time, orthodontic treatment takes place over the years as the child’s mouth grows and changes. A commitment to regular dental visits and good home care is a must. Orthodontic treatment is a significant financial investment as well. However, since it offers important health benefits, it may be covered at least in part by dental insurance.

Cosmetic Choices For Children and Teens

Visual Possibilities

• Before-and-after photos of microabrasion and bleaching techniques
• Before-and-after photos of bonding and veneers for discoloured and chipped teeth
• Photos of a porcelain crown, before and after placement

Restorative Dentistry

“Look Ma, no cavities” is what every parent wants to hear at the end of a dental appointment, and preventive dentistry is keeping more children free of decay than ever before. But when a child faces a dental problem, treatment is the right and responsibility of a parent. You have the right to be fully informed about the treatment choices for your child’s condition.

You have the responsibility to work with the dentist to make the best treatment decision for your child. If the child has tooth decay, new treatments are available that are far more attractive and comfortable than in the past. A parent can be a wise consumer if you know your options and discuss them with your dentist.

Why Fill Baby Teeth When They Fall Out Anyway?

While it is true that baby teeth do eventually come out, it is also true that they are important to a child in the meantime.

Primary or baby teeth hold space for the permanent teeth to grow in. If one is lost, the others can shift into the empty space and prevent the permanent tooth from erupting. This often means a crooked smile in a child’s future. In addition, a decayed tooth can become abscessed and cause discomfort for a child. Tooth decay causes significant pain, loss of school days and may lead to infections and even death.”  Left untreated, dental caries can result in a broad range of functional impairments that have far-reaching implications for growth, development, school performance, and peer relationships.

Preventive Resins: Excellent Choice For Cavities Caught Early

If a child has a tiny cavity on the chewing surface of a baby tooth or permanent tooth, then she may be a good candidate for preventive resin treatment. After the decay is removed, the tooth is filled with a tooth-coloured plastic and then coated with a sealant. The filling is virtually invisible, and the tooth is free of decay and protected by the sealant.

Tooth-Coloured Fillings: Virtually Invisible Treatment For Smaller Cavities

Tooth-coloured fillings are made from durable plastics called composite resins. Similar in colour and texture to natural teeth, the fillings are less noticeable and more attractive than other types of fillings. Your child can smile, talk and eat with confidence. Certain tooth-coloured filling materials (such as glass ionomers) even release fluoride, resulting in a tooth that is more resistant to decay. In addition, tooth-coloured fillings are compatible with dental sealants. A tooth can be filled and sealed at the same time to provide extra decay protection.

Resin fillings are not for every cavity. They work best in small areas of decay in low-stress areas. A dentist may not recommend a tooth-coloured filling for a large cavity in a back tooth. Resin fillings may cost more than amalgam (silver) fillings because they take longer to place. Plastic fillings are not as durable as metal fillings.

Amalgam Fillings: A Strong, Practical Choice For Children

Amalgams, the silver-coloured fillings you probably got as a child, are still serving children well today.

Amalgam fillings are made of a mixture of metals including silver, copper, tin, and mercury. Their relative low cost, ease of placement, and durability contribute to their continued use. However, amalgam fillings require removal of healthy tooth structure in order to achieve adequate retention. Because they lack the aesthetic appeal of composite resins, their use is limited to back teeth with small to moderate sized cavities.

Used for over 100 years, amalgam fillings have been proven safe with patients all over the world. In a few rare cases, some patients are allergic to the metals used in amalgam fillings. If a child has an allergy to metals, a filling material other than amalgam may be chosen. Amalgam fillings should not be used in primary molars where decay is extensive or for patients who are at high risk for decay and have multiple and/or large cavities

Stainless Steel Crowns: A Cost-Effective Choice For Severe Decay

Why would a parent choose a crown for a child? Here are some possible reasons:

• If a cavity is not caught early, the decay can destroy so much of the tooth structure that there is not enough left to support a filling. A crown will save the tooth.
• If a child has a root canal, which will leave the tooth more susceptible to fracture, a crown is recommended.
• A crown can restore a tooth with a developmental defect or a tooth fractured in an accident.
• If a child is at high risk for cavities and compliance with daily oral hygiene is poor, a crown will restore the decay while protecting the remaining surfaces of the tooth.
• If a child’s cooperation is affected by age, behaviour or medical history, a stainless steel crown is likely to last longer and possibly decrease the frequency for sedation or general anaesthesia with its increased costs and risks.
• Stainless steel crowns are more cost effective and are the treatment of choice for large areas of decay.
• Stainless steel crowns have been used over 50 years to save teeth that otherwise would be lost or when other treatments would fail. One of the strongest and most durable services in dentistry, they last longer than fillings and cost less than other types of crowns. Their greatest disadvantage is that stainless steel crowns are not the colour of teeth, but the colour of polished silver.
• The treatment process is the same for stainless steel crowns as for tooth coloured crowns. First, the decay is removed from the tooth. Next, the tooth is made smaller so the crown can fit over it. The crown is cemented into place. 

Tooth-Coloured Crowns: A Strong Treatment With Natural Look

Tooth-coloured crowns can be selected as treatment for the same reasons as stainless steel crowns. For example, they are recommended for treating severe decay or restoring a tooth with a fracture or developmental defect. On the plus side, tooth-coloured crowns are natural looking and can provide an excellent cosmetic result for your child. On the minus side, they are more expensive, may be less durable and may require longer treatment time for a child.

There are 2 types of tooth-coloured crowns: preformed and custom-fabricated:

• Preformed crowns are stainless steel crowns with tooth-coloured veneers. They come in standard sizes, shapes and colour, and are adapted to a prepared baby tooth. Preformed aesthetic crowns are subject to fracture or loss of the facing.
• Custom-fabricated crowns are made in a laboratory to match the size, shape and colour of the patient’s natural teeth. They typically are made of metal covered with porcelain. Custom-fabricated porcelain crowns are reserved for permanent teeth that are fully erupted with the gum tissue at its adult position.

Restorative Choices for Your Child

Visual Possibilities

• Photos of a tooth-coloured filling
• Photos of an amalgam filling
• Photos of a crown before, during and after placement

Dental Care For Teenagers

Five Essential Facts For Teens

1. Teens should not feel that they have outgrown their need for dental visits – or their dentist. Dentistry for adolescents and teens is an important part of the advanced training of a dentist.
2. Gum disease (also called periodontal disease or gingivitis) is not just a dental health risk, but also poses a risk to a teen’s appearance. It affects six out of ten teenagers, causing red or swollen gums, bleeding gums or bad breath. The best prevention is brushing, flossing and regular dental visits.
3. As a teenager’s body grows during the teen years, a teen’s face and jaws will grow and change as well. During the teen years, teens probably will lose their last baby teeth, get their remaining permanent teeth, and experience growth in the face and jaw. Teens can be healthy and attractive through these changes by eating a well-balance diet, taking good care of their teeth and visiting their dentist.
4. By the end of the teen years, teens probably will get the last of their permanent teeth, called wisdom teeth or third molars. Although some third molars come into the mouth normally, others need to be removed because of their position or lack of space. A dentist will make sure any treatment needed for a teen’s third molars takes place at the right time.
5. For chipped or discoloured teeth, new treatments in cosmetic dentistry can restore the look of a teen’s smile. Teens should talk to their dentist about treatment choices to help them feel more confident about their appearance.

Oral Health Checklist For Teens

An important change at this time in a teen’s life is taking responsibility for his dental health and eating habits. Teens can protect their health, smile and overall appearance with the following checklist.

• Did you know the average teen eats nine times a day? Choose wisely! Even though your schedule is hectic and you eat on the run, you can select fresh fruits and vegetables instead of junk foods. Cheese, air-popped popcorn and yogurt are healthy alternatives to high-fat or high-sugar snacks. For the sake of your dental health and your waistline, do not let snacks take the place of nutritionally balanced meals.
• When you do not have time to brush after a snack or a meal, clear the food from your teeth with a swish and rinse of water. Or try sugarless gum with xylitol. Although it is not in the same league as brushing in terms of effectiveness, it can help prevent tooth decay.
• Brush twice a day – after breakfast and before bed – with fluoride toothpaste. Floss once a day to prevent gum disease and tooth decay on the sides of the teeth where the toothbrush cannot reach.
• Wear a mouth guard during any sport or activity with a risk of falls, collisions or contact with hard surfaces or equipment. This includes sports such as football, baseball, basketball, soccer, hockey, wrestling and gymnastics, as well as leisure activities such as skateboarding, skating and bicycling.
• Buckle up in the car. A seat belt and shoulder harness can keep your face from striking the steering wheel, the dashboard or windshield during even minor accidents. And please, do not forget your helmet when you head out on your bicycle, motorcycle, skateboard or inline skates.
• Skip the mouth jewellery. Piercing your tongue, cheek or lip can pose greater risks than piercing such other places as your ear or eyebrow. During or right after the piercing, you face the chance of severe bleeding if the needle hits a blood vessel, infection from the bacteria in your mouth, and difficulty in breathing if your tongue swells. Down the road, you face the risk of recurrent infection, injury to the sensitive tissues in your mouth, chips or cracks in your teeth from contact with the jewellery, and choking if the hoop, stud or barbell comes loose. Finally, although some people get used to mouth jewellery, others find it difficult to speak and chew.
• Visit your dentist twice a year. Teeth cleanings, fluoride treatments and sealants are still important for you to prevent tooth decay, gum disease and bad breath.
• An accurate, comprehensive, and up-to-date medical history is necessary for correct diagnosis and effective treatment planning. If there are details about your dental or health history that your parents cannot provide, it is essential that you share that information with your dentist. This can be done in way that maintains your right to confidence.

Benefits Of A Healthy Smile

• Brighter smile
• Fresher breath
• More self-assurance when you talk and laugh
• Greater confidence in your appearance
• More comfort when you eat
• Better attendance and attention in school
• Better overall health
• Fewer dental visits and lower dental bills for your parents

Please note that some information has been adapted from the AMERICAN ACADEMY OF PEDIATRIC DENTISTRY 2013 ‘Fast Facts’ factsheet